Newbie Needs Advice-Please Help-I Want To Be Approved!!!

OK, first I would love to say hi to everyone, I am just learning my way around the site, and I am very excited about all of the resources and info I am finding here!! In January of 2006, my insurance( Empire BCBS Basic) will go into effect....is there anything I should or could do now to ensure that my surgery will be approved?? I have a BMI of 40 with 2 comorbidities (infertility and depression) Also, should I go ahead and make an appointment to see the doc I have chosen now or wait until insurance kicks in?? I am hoping that someone here has had the same or similar experience or insurance and can help.... Any and all info would be greatly appreciated!! Thanks in advance, Rosey

Hi Rosey!!! I would start checking in with your primary doc with weigh ins. Be sure he has a diagnosis of obesity and that his records show your weight gain. Start learning about the surgery and preparing yourself and family. Your bmi is similar to what mine was, and I got approved on the first appeal letter. My insurance required me to have 5 years of weight loss records and stuff from the doc! But that is really un usual. Perhaps my profile will have some helpful hints on it. I have a pre and post op section of suggestions. I would be sure my primary doc is 100% supportive, then I would look for a surgeon and start checking him out. Go to the information meeting he has on the surgery and they will give you a packet to help you know what things you need to start doing. You don't want to have too many tests done too early, before approval, as you might have to repeat them. The psych test had to be done before things were put into insurance. It might be different with your doc, so its good to go to the informational meeting and start working with the insurance person at the surgeons office. Hope this helps! blessings, Tami

I had Empire when I had my surgery, although I had a BMI of 62 at the time. You might want to check to make sure infertility and depression are considered comorbidities. If I'm not mistaken, they weren't when I had mine. It had to be medical like hypertension, sleep apnea, diabetes, etc. Other than that I just had to provide 5 years of medical records showing I was morbidly obese for the last 5 years, 1 year of diet history, a letter from my pcp, and a letter from my surgeon. I didn't have any probs with empire. Hugs Kim

i agree with tami and kim's responses good luck on your journey

best of luck to you and welcome to the board. Hope all goes as well as plan. I too had a comorbiditie of infertlilty and well........ July 4th I am due!!!!!! best wishes, heather